Introduction: The semi-Fowler position, defined as a body position at 30° head-of-bed elevation, has been shown to increase intra-abdominal pressure.
Aim: To investigate the impact of semi-Fowler positioning in addition to the pulmonary recruitment manoeuvre (PRM) on post-laparoscopic shoulder pain.
Material And Methods: One hundred and six patients (mean age: 43 ±12 years) undergoing gynaecologic laparoscopic surgery (LS) were included. The patients were divided into three groups: group 1 consisted of patients receiving PRM in the neutral position, group 2 comprised patients receiving PRM in the semi-Fowler position, and patients in the control group received neither PRM nor additional positioning. Information concerning wound and shoulder pain (post-laparoscopic shoulder pain - PLSP) at postoperative 6, 12 and 24 h was recorded using a visual analogue scale (VAS) for each patient.
Results: The PLSP scores at postoperative 6 h (5.71 ±0.86, 5.28 ±0.84 and 6.61 ±0.91, respectively, p < 0.001), 12 h (4.41 ±0.83, 4.01 ±0.82 and 5.32 ±0.97, respectively, p < 0.001), and 24 h (3.24 ±0.78, 2.44 ±0.73 and 4.34 ±0.85, respectively, p < 0.001) were significantly different among the groups, the lowest being in those who received PRM in addition to semi-Fowler positioning.
Conclusions: Semi-Fowler positioning in addition to PRM significantly reduces post-laparoscopic shoulder pain. We assume that the benefit gained using the semi-Fowler positioning is mainly derived from its potential to better evacuate the remaining abdominal gas following LS.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939207 | PMC |
| http://dx.doi.org/10.5114/wiitm.2019.84384 | DOI Listing |
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